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Exploring the Influence of Social Determinants of Health for Emergency Department Visits by Patients with Diabetes and Hypertension
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Genre
Poster (Research)
Date
2023-11-12
Advisor
Committee member
Department
Health Services Administration and Policy
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DOI
https://doi.org/10.34944/x76e-jq91
Abstract
Background/Objective: Type 2 diabetes (T2D) and hypertension are two of the most common chronic diseases observed in the emergency department (ED). It is increasingly critical to identify high-risk patients for ED to improve care and reduce healthcare costs. This study aims to explore the influence of social determinants of health (SDoH) on ED visits.
Methods: We studied 37,320 patients with T2D and hypertension in Philadelphia, who generated 1,348,614 clinical encounters between 2017 and 2021. The zip-code SDoH factors are linked with clinical variables (e.g., patient demographics, encounter information, and diagnoses). Geographic analysis, linear regression, support vector machines, random forest, and XGBoost were applied to the integrated dataset to identify high-risk factors for ED visits.
Results: About 56% (21,060) of patients had at least one ED visit. The results showed geographical disparities among 30 zip-codes in Philadelphia. The integrated clinical and SDoH data resulted in better predictive performance in all predictive algorithms. Predicting results showed that XGBoost performed the best with an area under the receiver operating characteristic (AUROC) of 0.76, 0.73, and 0.69 for the integrated data, clinical variables only, and SDoH only, respectively. The most significant features were various pains (with ICD-10 codes of R10, R07, M54) and disorders (M79, E87, E78, N39), mental health (F32), smoking (F17), house value, social polarization, income, and education.
Discussion/Conclusions: SDoH factors are significant predictors of ED visits among patients with T2D and hypertension. diabetic patients, which are important in developing targeted interventions for high-risk ED patients at different geographical locations.
Description
A poster presented at the APHA 2023 Annual Meeting and Expo, which took place November 12-15, 2023 in Atlanta, GA. https://apha.confex.com/apha/2023/meetingapp.cgi/Person/2795207
Citation
Mohammad Alizadeh, J. et al. (2023, November). Exploring the Influence of Social Determinants of Health for Emergency Department Visits by Patients with Diabetes and Hypertension. Poster presented at the APHA 2023 Annual Meeting and Expo, Atlanta, GA.
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